| NPI | 1508024431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERLIE A ROSALIN Office Manager 916-691-1141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 48953) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2008-07-05 |